The epidemic characteristics of differentiated thyroid cancer(DTC)are changing, thyrotropin(TSH)suppressive therapy is also improving in recent years. The risks of recurrence and the death of patients, as well as the adverse effects of levothyroxine sodium treatment should be fully considered during thyroid hormone administration for patients of DTC. Hence, the degree of TSH suppression should be individualized in patients with DTC.

Child, Preschool ; Diagnosis, Differential ; Female ; Gonadotropin-Releasing Hormone ; therapeutic use ; Humans ; Hysteroscopy ; Pediatrics ; Puberty, Precocious ; diagnosis ; therapy ; Uterine Hemorrhage ; diagnosis ; etiology ; therapy ; Vaginal Diseases ; diagnosis ; etiology ; therapy

T),resulting in His to Leu(CAT→CTT) substituted at codon 435(H435L).No mutation was identified in the patient's parents.HT occurred in the patient during following-up.Conclusion H435L mutation in exon 10 of TR? gene leads to resistance to thyroid hormone.Meanwhile,consistent RTH might lead to HT.

OBJECTIVE:To explore the role of clinical evidence-based pharmacy in anticoagulant treatment strategies during continuous renal replacement therapy (CRRT). METHODS:Taking a thrombocytopenia patient of anticoagulant treatment during CRRT for instance,clinical pharmacists analyzed the evidence of taken argatroban anticoagulant therapy during CRRT for high risk blooding and thrombocytopenia patients based on evidence-based pharmacy combined with clinical data,monitored the efficacy and safety and evaluated the treatment process. RESULTS:Totally five literature about anticoagulant treatment strategies during CRRT for high risk blooding and thrombocytopenia patients were obtained,including one systematic review,one RCT and three cohort studies. Based on the above evidences,good results were achieved in the clinical practice of this patient,no thrombotic or hemor-rhagic complications occurred in this patient,platelet count and coagulation indicators of patients also improved. CONCLUSIONS:Evidence-based pharmacy plays an important role in anticoagulant treatment strategies during CRRT.

The present study identified the properties of porins in the outer membrane in Pseudomonas aeruginosa,and showed the role of outer membrane in determining imipenem diffusion in Pseudomonas aeruginosa. The molecular weight of the major outer membrane protein was analyzed by SDS-PAGE. The purification of the porins in Pseudomonas aeruginosa was achieved by DEAE ion - exchange HPLC. The purified outer membrane proteins were reconstituted with phosphatidylcholine and dicetylphosphate into membrane vesicles, and were tested by the liposomes swelling method for the diffusion of imipenem. The permeability assay showed that OprC (70 kD), OprD2 (46kD), and OprE(43 kD) were the channel- forming proteins. But only OprD2 was thought to be the likely route of imipenem diffusion.

OBJECTIVEThis research aimed to study the inhibitory effect of xylitol on the growth and acid production of Actinomyces viscosus (A. viscosus).

METHODSWe cultivated A. viscosus in anaerobic conditions with different concentrations (128, 64, 32, 16, 8, and 4 g x L(-1)) of xylitol brain heart infusion liquid medium and determined the minimum inhibitory concentration (MIC). Subsequently, we measured the pH value of the control group, as well as those of 1/2, 1/4, 1/8 MIC, and MIC concentration groups at 1.5, 3, 6, 12, 24, and 48 h. The Delta pH and OD550 at 2, 4, 6, 8, 10, and 12 h were calculated. We discovered that the minimum xylitol concentrations suppressed 50% and 90% A. viscosus biofilm formation (i.e., MBIC50 and MBIC90). SPSS 19.0 was used to analyze the collected data, and conclusions were drawn afterward.

RESULTSXylitol inhibited the growth ofA. viscosus at MIC of 64 g x L(-1). After 12 h, the differences of pH value among groups were all statistically significant (P < 0.05), and Delta pH increased when the MIC concentration decreased. Except for the 1/2 MIC and MIC groups, the differences of OD550 among groups had no statistical significance (P>0.05), and OD550 also increased when the MIC concentration decreased. These results imply that the ability ofA. viscosus to grow and produce acid in 1/2 MIC and MIC conditions will be reduced with the increase in xylitol concentration. The value of MIBC50 was 64 g x L(-1), whereas the value of MIBC90 was 128 g x L(-1). This finding indicates that the xylitol medium can restrict A. viscosus biofilm formation.

CONCLUSIONXylitolcan effectively inhibit the growth, adhesion, and acid production ofA. viscosus, protecting teeth from cariogenic bacteria and preventing caries to a certain extent.

Objective To analyze the level of Th17 and Treg cells in the peripheral blood of patients with rheumatoid arthritis(RA),and to investigate its role in the pathogenesis of RA and the clinical significance.Methods Flow cytometry(FCM)was used to analyze the ratio of interleukin(IL)-17+CD4+T (Thl7)cells and Foxp3+CD25+CD4+T(Treg)cells in CD4+T cells from the peripheral blood of 57 RA patients and 32 normal controls.T-test and Chi-square test were used for inter-group comparison and Pearson's linear analysis was used for correlation analysis.Resuits Compared with normal controls.the level of both IL-17+CD4+T cells and the ratio of Th17/Treg in RA patients increased significantly.while the level of Foxp3+CD4+CD25+T cells decreased markedly[(4.2±2.2)%vs(2.3±1.4)%,P=0.000;1.15±0.62 I)5 0.34±0.17,P=0.000;(3.9±1.6)%vs(7.0±2.2)%,P=0.000].Compared with early RA(persistent for 2 years or less)patients,the levels of Th17,Treg and the ratio of Th17/Treg in chronic RA(duration for more than 2 years)patients didn't markedly changed(P>0.05).The level of Th17 cells and the ratio of Th17/Treg was directlycorrelated with disease activity parameter (including tender ioint counts,visual analog seale of patients,disease activitv score in 28 joints,etc).Regression analysis discovered that risk factors of bone erosion were the level of Th17 cells,the ratio of Th17/Treg,disease activity score in 28 joints and disease duration.Antirheumatic drugs could decreascthe ratio of Th 17/Treg.Conclusions Treg cells is decreased in RA patients while Th7 cells is increased in patients with RA.Th17/Treg ratio goes up significantly as well.Change of T celt subsets,especially Th17 and Treg cells are important for the pathogenesis of RA.Th17 and Treg cells could aggrevate disease activity and bone destruction throughout the whole disease process.Anti-rheumatic medications is effective by regulating Th17/Treg subset balance.

Objective To investigate whether MICA gene exon 2,3 and 4 polymorphism is associated with seronegative spondylarthropathies (SpA) or not in Chinese Han population.Methods All 199 B27 positive patients with SpA and 183 randomly ethnically matched healthy controls,and 12 B27 positive controls were enrolled to detect the MICA genotype from its exons 2,3 and 4 by using PCR SSOP method in Shanghai area.Results The MICA007 allele frequency was significantly more in the patient group (18 0%) than in the randomly healthy control group (6 6%) (RR=3 04, P =0 000 045).However,the MICA007 allele frequency was not significantly higher in the B27 positive patient group than in the B27 positive control group.Conclusion The MICA007 allele itself may not be the real disease susceptibility gene involved in the development of ankylosing spondylitis.The increased frequency of MICA007 allele is supposed to be due to a strong linkage disequilibrium between MICA and HLA B genes.

Objective To study the relationship between human leukocyte antigen-DRB1 (HLA-DRB1) allele genes polymorphism and intrahepatic cholestasis of pregnancy (ICP). Methods Forty-two patients with ICP were tested for HLA-DRB1 allele genes polymorphism with the polymerase chain reaction technique and sequence specific oligonucleotide (PCR-SSO) probes hybridization, 56 normal pregnant women as control group were also tested. In addition, the phenotype frequencies of HLA-DRB1 alleles were compared with it′s clinical character in patients with ICP. Results The higher frequencies were observed for alleles DR9, DR12 and DR4 in both groups. DR6 alleles were detected in 14 cases out of 42 patients. Patients with ICP had a significantly higher frequency of the allele DR6 when compared to control group (16.7% vs 3.6%), with a relative risk (RR) as 6.5 (P

Objective To investigate whether the killer cell immunoglobulin like receptor (KIR) gene polymorphisms are associated with seronegative spondylarthropathies.Methods All 197 HLA B27 positive patients with seronegative spondyloarthro pathies (SpA) and 83 randomly ethnically matched healthy controls were enrolled to detect the KIR genotype using PCR SSP in Shanghai area.Results The KIR3DL1 gene frequency was significantly lower in the patient group (0 763) than in the control group (1 00) (RR=0 76, P =0 003).Meanwhile,the gene frequencies of two pseudogenes (KIR2DP1,KIR3DP1) were significantly higher in SpA group than in healthy control group (RR=1 1, P =0 004).Conclusion There may be a negative association between pathogenesis of SpA and KIR3DL1 gene.The function of KIR3DL1 molecule should be investigated deeply.